Predicting overall survival and prophylactic cranial irradiation benefit in small cell lung cancer patients: a multicenter cohort study

Abstract Background To construct a CT-based radiomics nomogram, enabling the estimation of overall survival (OS) in small cell lung cancer (SCLC) patients and facilitating the identification of prophylactic cranial irradiation (PCI) beneficiaries through risk stratification using the radiomics score...

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Main Authors: Xiaomin Zheng, Kaicai Liu, Zhao Gao, Cuiping Li, Li Tong, Chang Rong, Shuai Li, Yichao Liu, Xingwang Wu
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-024-13274-7
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author Xiaomin Zheng
Kaicai Liu
Zhao Gao
Cuiping Li
Li Tong
Chang Rong
Shuai Li
Yichao Liu
Xingwang Wu
author_facet Xiaomin Zheng
Kaicai Liu
Zhao Gao
Cuiping Li
Li Tong
Chang Rong
Shuai Li
Yichao Liu
Xingwang Wu
author_sort Xiaomin Zheng
collection DOAJ
description Abstract Background To construct a CT-based radiomics nomogram, enabling the estimation of overall survival (OS) in small cell lung cancer (SCLC) patients and facilitating the identification of prophylactic cranial irradiation (PCI) beneficiaries through risk stratification using the radiomics score (RS). Methods A retrospective recruitment of 375 patients with pathologically confirmed SCLC was conducted across three medical centers, followed by their division into different cohorts. To generate the RS, a series of analyses were performed, including Pearson correlation analysis, univariate Cox analysis, and least absolute shrinkage and selection operator (LASSO) Cox regression analysis. Subsequently, patients were stratified into either the low RS or high RS group, determined by identifying the optimal RS cutoff value. Subsequently, a radiomics nomogram was constructed using the RS, followed by assessments of its discrimination, calibration, clinical utility and reclassification. Moreover, we evaluated the potential benefits of PCI following stratification by RS. Results For the internal and external validation cohorts, the radiomics nomogram (concordance index [C-index]: 0.770, 0.763) outperformed clinical nomogram (C-index: 0.625, 0.570) in predicting OS. Besides, patients with high RS had survival benefit from PCI in both the limited and extensive stage (hazard ratio [HR]: 0.304, 95% confidence interval [CI]: 0.087–1.065, P = 0.003; HR: 0.481, 95% CI: 0.270–0.860, P = 0.019, respectively), while no significant association were observed in patients with low RS. Conclusion A radiomics nomogram based on CT shows potential in predicting OS for individuals with SCLC. The RS could assist in tailoring treatment plans to identify patients likely to benefit from PCI.
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spelling doaj-art-fd43b40b9b5c477aa80c22b548f3339d2025-08-20T02:30:54ZengBMCBMC Cancer1471-24072024-12-0124111410.1186/s12885-024-13274-7Predicting overall survival and prophylactic cranial irradiation benefit in small cell lung cancer patients: a multicenter cohort studyXiaomin Zheng0Kaicai Liu1Zhao Gao2Cuiping Li3Li Tong4Chang Rong5Shuai Li6Yichao Liu7Xingwang Wu8Department of Radiology, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Radiology, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of ChinaDepartment of Radiology, The Third Affiliated Hospital of Anhui Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Anhui Medical UniversityDepartment of Radiology, The Affiliated Bozhou Hospital of Anhui Medical UniversityDepartment of Radiology, The First Affiliated Hospital of Anhui Medical UniversityAbstract Background To construct a CT-based radiomics nomogram, enabling the estimation of overall survival (OS) in small cell lung cancer (SCLC) patients and facilitating the identification of prophylactic cranial irradiation (PCI) beneficiaries through risk stratification using the radiomics score (RS). Methods A retrospective recruitment of 375 patients with pathologically confirmed SCLC was conducted across three medical centers, followed by their division into different cohorts. To generate the RS, a series of analyses were performed, including Pearson correlation analysis, univariate Cox analysis, and least absolute shrinkage and selection operator (LASSO) Cox regression analysis. Subsequently, patients were stratified into either the low RS or high RS group, determined by identifying the optimal RS cutoff value. Subsequently, a radiomics nomogram was constructed using the RS, followed by assessments of its discrimination, calibration, clinical utility and reclassification. Moreover, we evaluated the potential benefits of PCI following stratification by RS. Results For the internal and external validation cohorts, the radiomics nomogram (concordance index [C-index]: 0.770, 0.763) outperformed clinical nomogram (C-index: 0.625, 0.570) in predicting OS. Besides, patients with high RS had survival benefit from PCI in both the limited and extensive stage (hazard ratio [HR]: 0.304, 95% confidence interval [CI]: 0.087–1.065, P = 0.003; HR: 0.481, 95% CI: 0.270–0.860, P = 0.019, respectively), while no significant association were observed in patients with low RS. Conclusion A radiomics nomogram based on CT shows potential in predicting OS for individuals with SCLC. The RS could assist in tailoring treatment plans to identify patients likely to benefit from PCI.https://doi.org/10.1186/s12885-024-13274-7RadiomicsSmall cell lung cancerOverall survivalProphylactic cranial irradiation
spellingShingle Xiaomin Zheng
Kaicai Liu
Zhao Gao
Cuiping Li
Li Tong
Chang Rong
Shuai Li
Yichao Liu
Xingwang Wu
Predicting overall survival and prophylactic cranial irradiation benefit in small cell lung cancer patients: a multicenter cohort study
BMC Cancer
Radiomics
Small cell lung cancer
Overall survival
Prophylactic cranial irradiation
title Predicting overall survival and prophylactic cranial irradiation benefit in small cell lung cancer patients: a multicenter cohort study
title_full Predicting overall survival and prophylactic cranial irradiation benefit in small cell lung cancer patients: a multicenter cohort study
title_fullStr Predicting overall survival and prophylactic cranial irradiation benefit in small cell lung cancer patients: a multicenter cohort study
title_full_unstemmed Predicting overall survival and prophylactic cranial irradiation benefit in small cell lung cancer patients: a multicenter cohort study
title_short Predicting overall survival and prophylactic cranial irradiation benefit in small cell lung cancer patients: a multicenter cohort study
title_sort predicting overall survival and prophylactic cranial irradiation benefit in small cell lung cancer patients a multicenter cohort study
topic Radiomics
Small cell lung cancer
Overall survival
Prophylactic cranial irradiation
url https://doi.org/10.1186/s12885-024-13274-7
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